Reliance on this Covid-19 vaccine

[Bantamzen]

Sadly I don't believe that is correct, otherwise the "handwashing etc" approach would have been enough and it wasn't.

In part that is because this is a new virus, and in part because governments were slow to react & get at least testing regimes in place, not to mention to have listened to advice for many years from experts saying that spare capacity should always be built in. Now if governments take heed going forwards, the next new virus, and there will be many, can be handled very differently.

However there may never be a vaccine, just ways to treat the effects and so we cannot simply treat ourselves as risk factors. We can't, that's the bottom line. And so we must move back to a close to our original position as possible, and mitigate the risks as we do. If basic handwashing, & not coughing all over people was not an effective method, humanity would have been wiped out a very long time ago.

While I disagree that simple hygiene and common sense are unlikely to mitigate the risk long term by themselves, I personally think they're all we can afford to do long term unless we want to see society and our economy continue to collapse. In fact, I personally feel that both are already well on their way to total collapse.

That you don't agree is fair enough, I do think however that they for the most part will. What we could do with is more options to be able to wash our hands, e.g. more public convivences that are well maintained, and that people learn to cover their mouths & noses when coughing or sneezing, perhaps doing as they do in East Asia in particular and wear a mask when they have symptoms. But things like wearing masks all the time, especially when many don't actually provide that much protection from the virus, or keeping 2 metre or more distance from each other are methods that are just not workable even for more than a few months, let alone years. As you rightly note, the basics are really all we as citizens can really do in the long run, it is up to governments to provide the infrastructure to allow us to keep as high a level of hygiene as possible, and to provide the healthcare capacity in at least warm storage for when future outbreaks occur (and not just for this virus).

 

[6862]

I totally agree that we should increase hygiene capacity, and the ways you suggest sound like good ideas. But I just don't think that we can rely on them to be totally effective, as the past few months have shown we can't rely on any aspect of healthcare or the state to function perfectly.

 

[Bletchleyite]

However there may never be a vaccine, just ways to treat the effects and so we cannot simply treat ourselves as risk factors. We can't, that's the bottom line. And so we must move back to a close to our original position as possible, and mitigate the risks as we do. If basic handwashing, & not coughing all over people was not an effective method, humanity would have been wiped out a very long time ago.

Humanity wouldn't have been wiped out even if the virus was allowed to spread unchecked, though it would have reduced the population by about 1-2% disproportionately towards the older and those with medical conditions.

 

[PTR 444]

In the event that there will be no vaccine, we will have to fully reopen society regardless. There is now way that this time next year, we can still be living under the same restrictions as we are now. I hate to say this but there will be ten times more deaths from the causes listed below than those from covid-19 in the long run, all of which will be directly or indirectly related to the virus:

• Obesity
• Domestic violence
• Suicide
• Civil unrest
• Alcohol/drug abuse
• Cancer (as a result of missed treatments)
• Malnutrition
• Other health conditions that require hospital treatment

Not to mention the long term economic impact and additional pressures on the NHS these deaths would cause. Would you rather have a society with tens of thousands of deaths from all the causes above, or one where covid-19 is present but only causes a fraction of those deaths?

 

[6862]

Would you rather have a society with tens of thousands of deaths from all the causes above, or one where covid-19 is present but only causes a fraction of those deaths?

Well said.

 

[Domh245]

This is a worrying point: the latest ONS figures show 18,516 deaths in England & Wales for the week ending 10th April, up from 10520 as the 5 year average. 6213 of these were COVID, or about a third of the total - that seems terrible but that means that there were 1783 excess deaths that weren't COVID related, and that number will only climb as the lockdown continues, operations are postponed and people don't seek the medical help they need out of fear

 

[HH]

This is a worrying point: the latest ONS figures show 18,516 deaths in England & Wales for the week ending 10th April, up from 10520 as the 5 year average. 6213 of these were COVID, or about a third of the total - that seems terrible but that means that there were 1783 excess deaths that weren't COVID related, and that number will only climb as the lockdown continues, operations are postponed and people don't seek the medical help they need out of fear

I think you've made an assumption that may not be true, i.e. that all the deaths not registered as covid-related are nothing to do with covid. Fact is that many deaths outside hospitals are not being tested and it is likely that some of those deaths will have been affected by covid (I don't think anyone has an idea of how many).

 

[Bletchleyite]

I think you've made an assumption that may not be true, i.e. that all the deaths not registered as covid-related are nothing to do with covid. Fact is that many deaths outside hospitals are not being tested and it is likely that some of those deaths will have been affected by covid (I don't think anyone has an idea of how many).

But countering that some deaths are being registered as COVID that might have actually been primarily caused by something else. I believe if the death is in hospital and the patient has tested positive it's recorded as COVID even if it might have been something else, unless it's really obviously not e.g. trauma.

 

[Bantamzen]

But countering that some deaths are being registered as COVID that might have actually been primarily caused by something else. I believe if the death is in hospital and the patient has tested positive it's recorded as COVID even if it might have been something else, unless it's really obviously not e.g. trauma.

As it is a notifiable disease, COVID has to be reported on death, regardless as to whether it was a primary or secondary cause, or even if it was not a factor.

 

[Bletchleyite]

As it is a notifiable disease, COVID has to be reported on death, regardless as to whether it was a primary or secondary cause, or even if it was not a factor.

You are probably right there - the death figures are "people who died with COVID" not "people who died of COVID", so presumably, then, it appears in the figures if they tested positive regardless, though I doubt they'd be running a test on someone admitted with severe trauma from a car crash?

 

[Bantamzen]

You are probably right there - the death figures are "people who died with COVID" not "people who died of COVID", so presumably, then, it appears in the figures if they tested positive regardless, though I doubt they'd be running a test on someone admitted with severe trauma from a car crash?

I'm not sure about accidents, I suppose it would depend if any hospital care was needed prior to the accident as I suppose treating someone after an crash there would still be a risk they could be carrying the virus so staff would still need to know.

 

[JonathanP]

An growing theme on the news in Germany is that the number of patients in GP surgeries is far reduced below normal because people are worried about going there, and the doctors are concerned that people who really ought to be seen by a doctor are staying at home. One doctor mentioned a patient who had a mild heart attack but didn't seek medical treatment.

In a development I never expected to see, GP's are even complaining that they might get into financial difficulties as a result of the pandemic, because in Germany they are paid per appointment by the insurance companies.

 

[Domh245]

I think you've made an assumption that may not be true, i.e. that all the deaths not registered as covid-related are nothing to do with covid. Fact is that many deaths outside hospitals are not being tested and it is likely that some of those deaths will have been affected by covid (I don't think anyone has an idea of how many).

Taken from the introductory page of the ONS dataset:

Because of the coronavirus (COVID-19) pandemic, our regular weekly deaths release now provides a separate breakdown of the numbers of deaths involving COVID-19. That is, where COVID-19 or suspected COVID-19 was mentioned anywhere on the death certificate, including in combination with other health conditions. Previously, the number of deaths with an underlying cause of respiratory disease was published a week behind the current week. These will now be published for the current week and revised the following week. Alongside this, a new bulletin summarises the latest weekly information and will be updated each week during the pandemic. A link to the bulletin can be found in the notice box on the weekly deaths dataset page.

So my understanding is that as long as it was suspected and recorded on the Death certificate, it's been logged, even if not tested & confirmed. So unless coroners and medical professionals are going around ignoring reports that the deceased was showing symptoms then the deaths outside hosptials figure seems reasonable (about an extra 20% of the hosptial death count)

Total deaths in English care homes over the period of 28/12 to 10/4 is 40,286 or 2,686 a week with COVID cases averaging 65 a week over that period. I can't easily find any similar data sets showing weekly care home deaths but the annual average between 2018/19 Q4 and 2019/20 Q3 was 2134 a week which considering the potential seasonal variation doesn't seem particularly excessive, so it's not like there's an unexpected spike in total deaths either.

An growing theme on the news in Germany is that the number of patients in GP surgeries is far reduced below normal because people are worried about going there, and the doctors are concerned that people who really ought to be seen by a doctor are staying at home. One doctor mentioned a patient who had a mild heart attack but didn't seek medical treatment.

In a development I never expected to see, GP's are even complaining that they might get into financial difficulties as a result of the pandemic, because in Germany they are paid per appointment by the insurance companies.

I remember reading here that admissions to A&E for certain issues (possibly heart attacks and related, I can't remember) had dropped massively, but those people haven't stopped having said issues, they're just not going to hospital for it

 

[Bletchleyite]

An growing theme on the news in Germany is that the number of patients in GP surgeries is far reduced below normal because people are worried about going there, and the doctors are concerned that people who really ought to be seen by a doctor are staying at home. One doctor mentioned a patient who had a mild heart attack but didn't seek medical treatment.

In a development I never expected to see, GP's are even complaining that they might get into financial difficulties as a result of the pandemic, because in Germany they are paid per appointment by the insurance companies.

A difference with the German system is that you can go straight to a specialist if you're sure what is needed, though.

 

[Adam Williams]

Unless the kids have health issues that put them severely at risk, then that's a crazy decision. The vast majority of kids are not going to come to any harm with this disease. However the harm they could come to by being kept at home indefinitely is immense

I guess part of the concern needs to be around kids acting as a vector for the virus (mostly non-symptomatic), and that needs weighing up the ongoing detrimental effects of the isolation. How many of their teachers or parents are in an at-risk group?

I know of totally fit and healthy people who have turned into a nervous wreck and even fallen out with family members, because they have read about some healthy people dying from the disease and therefore they think it's likely that they will die if they get it. They're now in a far worse place to fight a virus because their immune system will now be weakened. The media have to take some responsibility for this, as do the sensationalist people who take the view that mental health, physical fitness and all sorts of other important factors for life quality should be completely disregarded.

It's definitely a difficult one to balance. Hysteria helps nobody and optimism is important for any recovery, but I think the virus does need to be taken seriously with some perspective.

Entirely anecdotally (and accepting that I don't have a positive test result and can only go off what I was told by my GP later on to be likely - i.e. that this was probably Covid-19), I had symptoms starting 6 weeks ago with a persistent cough. I self-isolate and start working remotely. In the first week, this escalated to include a slight fever and some muscle aches. Over weeks 2 and 3, my self-isolation is supposed to be finished but I start to experience shortness of breath and a tightness in my chest when breathing deeply. This was mostly worse in the evenings - I felt better each morning. Eventually it got to the point where it was difficult to sleep because breathing would just trigger another coughing fit. To be honest the symptoms related to the breathing which mostly cropped up at night were the most terrifying - on its worst days it felt like I was drowning. I was worried that if it got much worse I'd end up in hospital, it felt close to that point on a few occasions.

I was lucky though, in that I still able to do some work remotely throughout this earlier on when the symptoms were milder. I still did conference calls, managed to write code and do some support work.

I had started to feel better, but it was around about the end of week 3/start of week 4 that I experienced a bunch of GI symptoms and then progressively began to feel more and more fatigued. It got the point where I couldn't walk a mile without being completely exhausted afterwards, and just doing housework tasks and trying to cook food was a challenge. I contacted 111 & my GP who said it sounded like a mild case, a second wave of symptoms was relatively common, strongly advised that I stop working and trying to exercise for a bit and said straight up that it would take weeks to fully recover from the likely lung damage.

I was off work for around two weeks from this point, mostly just sleeping 12+ hours each day. In the second week I started to feel a bit better and I managed to do my first full day of work last Friday. I have a few symptoms that are sticking around but they're now more of an annoyance than a hindrance.

I really hope I'm statistically an outlier, because I'd never felt as ill as this before and I'm a reasonably healthy 22 23 year old (as of today!) so I feel like it should have been much milder than this. The whole thing has probably cost me about £2k in lost work (I believe I am entitled to £95.85 with my sick note ) that should have been done and invoiced, but I realise I'm incredibly lucky to have recovered as quickly as I did, to even have work to do at the moment and to work with clients that were understanding enough for me to take the time out.

So yes, a long rambling post to really say: hysteria and fear-mongering isn't helpful but it can be a pretty horrible experience if you do get it. I'm supportive of a lot of measures that might help to slow down the spread of the virus in this light. Hopefully if we buy ourselves some time we might be able to develop antiviral treatments that improve the symptoms and reduce the stress on the NHS.

 

[HH]

So my understanding is that as long as it was suspected and recorded on the Death certificate, it's been logged, even if not tested & confirmed. So unless coroners and medical professionals are going around ignoring reports that the deceased was showing symptoms then the deaths outside hosptials figure seems reasonable (about an extra 20% of the hosptial death count)

Total deaths in English care homes over the period of 28/12 to 10/4 is 40,286 or 2,686 a week with COVID cases averaging 65 a week over that period. I can't easily find any similar data sets showing weekly care home deaths but the annual average between 2018/19 Q4 and 2019/20 Q3 was 2134 a week which considering the potential seasonal variation doesn't seem particularly excessive, so it's not like there's an unexpected spike in total deaths either.

If you assume that overworked Doctors fill in every death certificate meticulously then maybe; it doesn't seem to tie up with all the reports from managers of care homes though. Plus there are significant delays in registering some deaths, so I would take those numbers with a bushel of salt.

I remember reading here that admissions to A&E for certain issues (possibly heart attacks and related, I can't remember) had dropped massively, but those people haven't stopped having said issues, they're just not going to hospital for it

There has been a significant reduction, I've seen 30-40% quoted. Whether that can be classed as massive possibly depends - there will have naturally been a reduction of the usual weekend drink-related injuries, a reduction in drug problems, a reduction in construction accidents, road accidents, etc. It's unclear if there really is a reduction in people attending hospital for heart attacks, strokes, etc. Detail would need to be provided to see what the causes of reductions are.

 

[cuccir]

I had started to feel better, but it was around about the end of week 3/start of week 4 that I experienced a bunch of GI symptoms and then progressively began to feel more and more fatigued. It got the point where I couldn't walk a mile without being completely exhausted afterwards, and just doing housework tasks and trying to cook food was a challenge. I contacted 111 & my GP who said it sounded like a mild case, a second wave of symptoms was relatively common, strongly advised that I stop working and trying to exercise for a bit and said straight up that it would take weeks to fully recover from the likely lung damage.

Thanks for this post and glad you're feeling better.

One issue, in the absence of mass testing, is that it will be hard to distinguish between the direct symptoms of infection, and symptoms of recovery or post-viral fatigue. My Dad had a severe bout of pneumonia in January and is only really reaching full fitness now. How in a case like yours or his, if it had been in a time-of-corona, someone is meant to distinguish between the disease and the recovery phase I don't know.

 

[Bletchleyite]

Thanks for this post and glad you're feeling better.

One issue, in the absence of mass testing, is that it will be hard to distinguish between the direct symptoms of infection, and symptoms of recovery or post-viral fatigue. My Dad had a severe bout of pneumonia in January and is only really reaching full fitness now. How in a case like yours or his, if it had been in a time-of-corona, someone is meant to distinguish between the disease and the recovery phase I don't know.

Particularly as post-viral lung damage can be permanent - I'm pretty sure this is how I ended up with asthma.

 

[Adam Williams]

One issue, in the absence of mass testing, is that it will be hard to distinguish between the direct symptoms of infection, and symptoms of recovery or post-viral fatigue.

Definitely, it could have just been the recovery in the latter phases. I didn't have a temperature later on. I do worry a little that 7 days is not long enough for self isolation, but as you point out we're not testing for viral load so who knows. Maybe I didn't have an active infection at that point but the stress of fighting it off, adjusting to big changes in the way of working and the stress of the project I'd been working on hit all at once.

My Dad had a severe bout of pneumonia in January and is only really reaching full fitness now. How in a case like yours or his, if it had been in a time-of-corona, someone is meant to distinguish between the disease and the recovery phase I don't know.

Good news that your Dad's approaching normality now, but jeez.. January.. it's genuinely scary how long the recovery can take in severe cases.

 

[Adam Williams]

Particularly as post-viral lung damage can be permanent - I'm pretty sure this is how I ended up with asthma.

Sorry to hear that

The human body is definitely more fragile than I'd really ever previously appreciated. You expect there to be some symptoms due to the immune response and then a recovery. Lasting damage is something I never really thought about.

 

[Meerkat]

Couldn’t some of the reduction in admittance for heart attacks be because Covid had killed off those susceptible? a heart attack still killed them, it was just triggered early bu Covid....

 

[Bantamzen]

Couldn’t some of the reduction in admittance for heart attacks be because Covid had killed off those susceptible? a heart attack still killed them, it was just triggered early bu Covid....

That's speculative at best, and frankly I seriously doubt is accurate.

 

[Greybeard33]

Total deaths in English care homes over the period of 28/12 to 10/4 is 40,286 or 2,686 a week with COVID cases averaging 65 a week over that period. I can't easily find any similar data sets showing weekly care home deaths but the annual average between 2018/19 Q4 and 2019/20 Q3 was 2134 a week which considering the potential seasonal variation doesn't seem particularly excessive, so it's not like there's an unexpected spike in total deaths either.

The ONS reported that:

When looking at the change in total deaths registered by place of occurrence between Week 11 (when the first COVID-19 deaths were registered) and Week 15, we see that the number of deaths in care homes has doubled from 2,471 deaths to 4,927 (99.4%). There has also been a 72.4% increase (4,975 deaths to 8,578) in deaths occurring in hospitals, and 51.1% increase in deaths occurring in private homes (2,725 deaths to 4,117).

When looking in more detail at the large increase in care home deaths we can see that in Week 11, care home deaths made up 22.4% of all deaths, which has risen to 26.6% of all deaths in Week 15. In Week 15, 16.8% (826 deaths) of all deaths occurring in care homes involved COVID-19. This is lower than the 57.8% of hospital deaths (4,957) that involved COVID-19, but higher than the 8.0% (330 deaths) that occurred in private homes.

https://www.ons.gov.uk/peoplepopula...2020#deaths-registered-by-place-of-occurrence

I would say that a doubling in the care home total death rate in the space of four weeks definitely constitutes an unexpected spike. Also the number of care home deaths involving Covid-19 quadrupled just between Week 14 and Week 15!

The number of coronavirus-related deaths in care homes more than quadrupled from 217 to 1,043 in the space of a week, new figures show.

https://news.sky.com/story/coronavi...overnments-hospital-only-figures-ons-11976357

The ONS has pointed out that Week 15 included Good Friday, when most registry offices were closed, so it is likely that the true numbers of deaths in that week were significantly higher than registered and so the spike in care home deaths was even greater than the ONS reported.

 

[Meerkat]

That's speculative at best, and frankly I seriously doubt is accurate.

It’s no more speculative than assuming they were people frightened out of going to hospital!

 

[Bantamzen]

It’s no more speculative than assuming they were people frightened out of going to hospital!

Actually it may not be:

Coronavirus: Deaths at 20-year high but peak may be over

Numbers dying nearly double above what would be expected, but peak may now be over, say experts.

www.bbc.co.uk

The figures presented by the ONS are different from those used by the government on a daily basis and the NHS England analysis. Those rely on hospital cases confirmed by tests, whereas the ONS has used death certificates which show both fatalities in hospital and in the community on a weekly basis. The figures show that the overall number of deaths topped 18,500. That is the highest since January 2000 when there was a bad flu outbreak. It is also much higher than the recent bad flu season of 2015.
More than 6,200 of these deaths were linked to coronavirus and Covid-19, the disease caused by the virus. One in six of these deaths happened outside hospital. But the ONS also said deaths from other causes rose too.
Nick Stripe, head of health analysis at ONS, said they were trying to understand and find out why this was. He said it could be that people with other illnesses were avoiding going to hospital for treatment - visits to A&E have halved since the pandemic started - or an under-reporting of coronavirus.
But he added it could "take years to work out". He also said it was important to remember the human toll in these figures. "Each one is a person. Each one has a family. We must always remember this." A similar trend is being reported in Scotland where there were nearly 2,000 deaths in the week up to 12 April. Deaths in Northern Ireland are also up.

 

[Meerkat]

Actually it may not be:

Coronavirus: Deaths at 20-year high but peak may be over

Numbers dying nearly double above what would be expected, but peak may now be over, say experts.

www.bbc.co.uk

All you have done there is prove it’s speculatio!

 

[Bantamzen]

All you have done there is prove it’s speculatio!

ONS also said deaths from other causes rose too.
Nick Stripe, head of health analysis at ONS, said they were trying to understand and find out why this was. He said it could be that people with other illnesses were avoiding going to hospital for treatment - visits to A&E have halved since the pandemic started​

Its not speculation that visits to A&E have reduced, and its not speculation that non-covid deaths are up. All that is under investigation is to why this is.​

 

[Meerkat]

Its not speculation that visits to A&E have reduced, and its not speculation that non-covid deaths are up. All that is under investigation is to why this is.

It’s no more speculative than assuming they were people frightened out of going to hospital!

But it is speculation that they were frightened out of going to hospital - which was my point.

 

[Bletchleyite]

Its not speculation that visits to A&E have reduced, and its not speculation that non-covid deaths are up. All that is under investigation is to why this is.

Part of the reasons for lower A&E demand will be fewer people doing things that land them in A&E normally, e.g. dangerous sports, contact team sports, DIY, driving cars (or being hit by them when cycling or walking), going out for 10 pints of Stella and a punch-up on a Saturday night etc.

I've got a hospital appointment for something non-urgent this afternoon, they're still doing it as they're quiet!

 

[Bantamzen]

But it is speculation that they were frightened out of going to hospital - which was my point.

Well true, but there is potential correlation between reduced A&E admissions and increased deaths not directly attributed to covid. Getting that data sorted will take time, but it is not an unreasonable assumption to say that there is likely to be correlation between being told to stay at home and these extra deaths.